Background: The functional outcome after stroke is improved by more intensive or sustained therapy. When the affected hand has no functional movement, therapy is mainly passive movements. A novel device for repeating controlled passive movements of paralysed fingers has been developed, which will allow therapists to concentrate on more complicated tasks. A powered cam shaft moves the four fingers in a physiological range of movement.

The influence of temperature, food, size and origin on the sexual differentiation of elvers (Anguilla anguilla). The effects of rearing and feeding conditions, as well as of body size and origin on sexual differentiation have been examined in elvers collected on the Atlantik coast (River Ems) and in the Tyrrhenian Sea. Raised at 17 °, 20 °, 23 °, 26 ° or 29 ° C and at constant photoperiod, the elvers received either commercial fish food or cod roe. Eels from the Tyrrhenian Sea mostly developed into males. To some extent, at temperatures optimal for growth (26 ° C) and feeding a cod-roe diet, a shift of sex ratio in favour of females was observed in Atlantic eels. The results obtained contradict those of FIDORA (1951), who, rearing elvers in ponds, found the percentage of male eels to be positively correlated with increasing stock density. Although in the present study, stock density was 200 times higher than in FIDORA'S experiments, the percentage of females was much higher than that of males. The results obtained support BELLINI'S (1907) findings that big elvers preferentially develop into females, but small elvers into males. Irrespective of elvers' origin, water temperature and diet, the onset of sexual differentiation dependends upon attaining a certain body length (15-25 cm), but not on age. Whereas under natural conditions females are supposed to grow faster than males, under the conditions tested the males grew faster than the females. It is concluded, that, in addition to genetic factors, various environmental factors may influence sex determination in eels.

SummaryPatients received 2,000 ml of dialysate intraperitoneally with five exchanges per day during continuous peritoneal dialysis (CAPD) for the treatment of terminal renal insufficiency. During a dwell time of 4 h the dialysate reached a total protein concentration up to 100 mg/dl by mass transfer of intravascular proteins. The composition is dependent on the molecular weight of the proteins. This results in an intraperitoneal hemostatic system of low concentration and different composition.We found an intraperitoneal fibrinogen cleavage and thrombin- antithrombin Ill-complex formation leading to increased levels of fibrinopeptide A (FPA: 33.3 ± 7.0 ng/ml) and thrombin-antithrombin Ill-complex (TAT: 4.7 ± 0.4 ng/ml) in plasma by mass transfer from dialysate to plasma. t-PA (tissue plasminogen activator) and PAI-1 (plasminogen activator inhibitor type 1) concentrations in plasma were within the normal range. The dialysate concentrations indicated a low local secretion. The fibrinolytic fibrin fragment D-dimer and the fibrinogen degradation product concentrations in plasma were greater than in dialysate. But the relations of the proteins between plasma and dialysate refer to a local intraperitoneal production as well.The results show that intraperitoneal coagulation predominates over fibrinolysis which is accompanied by an intravascular fibrinolysis in patients undergoing CAPD. Neoantigens produced in dialysate and diffused to plasma are comparable to changes seen in disseminated intravascular coagulation.

Uraemic patients are in general infertile. Ovarian function is, however, restored after successful renal transplantation, thus making conception possible. We followed up 14 patients after renal transplantation involving 16 pregnancies. Two patients became pregnant twice, one with twins and the other following renal and pancreatic transplantation--the first recorded in the world. Caesarean section was performed in all patients due to increasing serum creatinin levels, avoid pre-eclampsia or premature rupture of membranes. Both, mother and child in all cases progressed without complications, although these pregnancies are associated with high risk for both. Therefore, a close co-operation between the mother, the nephrologist, the transplantation centre, the gynaecologist and the paediatrician is a prerequisite for a possible favourable course.

The effects of continuous ambulant (CAPD) and continuous cyclic peritoneal dialysis (CCPD) on a series of laboratory parameters in the blood and dialysate were assessed in two groups of nine juvenile diabetics each, suffering from terminal renal failure. The CCPD patients showed higher urea and creatinine levels in serum and, as a result of lower protein loss via the dialysate, also higher total protein and transferrin concentrations than the CAPD patients. The glucose absorption of the CCPD patients was about 50% lower than of the CAPD patients. Control of diabetes was equally successful with both procedures, the HbA1 values were less than 10%. The triglycerides were lowered by both CAPD and CCPD on the condition that the absorbed glucose amounts were included in the calculation of the dietary adjustment. Cholesterol and HDL-cholesterol remained unchanged. Thus CCPD appears to have advantages over CAPD, especially with respect to the lowering of the glucose absorption and the protein loss. The wider application of both methods will be, however, less influenced by the metabolic parameters than by other factors such as reduction of the risk of peritonitis.